Northwoods Wellness Physical & Occupational Therapy, P.L.L.C

Organization Active NPI Occupational Therapist · Ticonderoga, NY

NPI 1003099078 · NPPES record last updated Jun 12, 2008

Key facts

NPI
1003099078
Entity type
Organization (NPI type 2)
Primary specialty
Occupational Therapist 225X00000X
License
007563-1 (NY)
Legal business name
NORTHWOODS WELLNESS PHYSICAL & OCCUPATIONAL THERAPY, P.L.L.C
Practice address
106 Montcalm St
Northwoods Wellness Physical & Occupational Therapy, P.
Ticonderoga, NY 12883-1353
Phone
(518) 585-9285
Fax
(518) 585-9286
NPI assigned
Dec 12, 2007
Organization subpart
No

Authorized official

Name
Mrs. Dawn Marie Bazan, MS, OTR/L
Title
Owner and Occupational Therapist
Phone
(518) 585-9285

Practitioners 3

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

National Provider Directory

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X 014005-1 NY
Physical Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225100000X 027321-1 NY
Occupational Therapist
Group: 193200000X MULTI-SPECIALTY GROUP
225X00000X 007563-1 NY Yes

Addresses

Primary practice location

106 Montcalm St
Northwoods Wellness Physical & Occupational Therapy, P.
Ticonderoga, NY 12883-1353

Mailing address

106 Montcalm St
Northwoods Wellness Physical & Occupational Therapy, P.
Ticonderoga, NY 12883-1353
Phone (518) 585-9285

Other providers in Ticonderoga, NY

All providers in Ticonderoga, NY · Occupational Therapist in New York

Sources for this page

Verify at the official NPI Registry.